POS0789-HPR STRUCTURES THAT FACILITATE PATIENT ENGAGEMENT IN THE DEVELOPMENT AND DELIVERY OF HEALTH CARE SERVICES: A SYSTEMATIC SCOPING REVIEW
Authors: J. Sagen, G. Smedslund, A. E. Simonsen, A. Habberstad, I. Kjeken, H. Solveig Dagfinrud, R. H. Moe
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> System-level patient engagement (PE) is required to improve future healthcare services. Structures that facilitate PE are likely to be diverse and complex, but are scarcely explored and described. <h3>Objectives</h3> To identify, summarize and map research about system-level PE structures in healthcare services. <h3>Methods</h3> A systematic scoping review was conducted, searching the MEDLINE, EMBASE, Cochrane, and PsycINFO databases. Key search elements were identified using the Population, Context, and Concept framework [1]. The population was patient representatives, healthcare professionals, managers, and leaders. The context includes practices, motives, and outcomes, and the concept was PE in the development and delivery of healthcare services. Studies published between 2005 and 2022 were included. The coding of extracted characteristics was inspired by a PE-adapted model to evaluate the quality of healthcare services [2]. Data was collapsed into structural attributes such as organisation, consistency, and timing of PE initiatives (Table 1), in addition to representativeness, PE knowledge, and finances. <h3>Results</h3> Of 8588 identified records, 37 studies were found to be eligible. Studies aimed to explore the impact of PE initiatives (n=8), increase knowledge and understanding about PE (n=15), and experience, attitudes, or opinions (n=9). Standing committees or panels were the most consistent PE initiatives, often acting as an established part of the structure (Table 1). Lack of PE knowledge was mentioned as a barrier in eighteen studies. Of these, eight reported that multiple stakeholders such as patients, healthcare professionals, and/or managers could benefit from increasing their PE knowledge. In twelve studies, lack of time and/or finances were listed as a barrier. High age, small numbers of patient representatives with time to spare, and professionals repeatedly recruiting the same patient representatives were described as a restriction for sufficient representativeness. <h3>Conclusion</h3> The findings indicate that the PE process may flourish through education, training, experience, and diversity among all PE stakeholders. Sufficient representativeness and PE knowledge were reported as essential structural attributes to facilitate equality and a meaningful co-creation process. Earmarked funds, sufficient to facilitate the PE structure are described as a cornerstone of integrating system-level PE in any environmental and healthcare setting. <h3>References</h3> [1]Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015;13(3):141-6. [2]Hamilton CB, Dehnadi M, Snow ME, Clark N, Lui M, McLean J, et al. Themes for evaluating the quality of initiatives to engage patients and family caregivers in decision-making in healthcare systems: a scoping review. BMJ Open. 2021;11(10):e050208. <h3>Acknowledgements</h3> The authors acknowledge the DAM foundation for funding, and the medical librarians at the VID Specialised University in Oslo for help with development and peer review of the search strategy. The authors also acknowledge The Norwegian Federation of Organisations of Disabled People for the initial project idea. <h3>Disclosure of Interests</h3> None Declared.